The arthritis drugs tocilizumab and sarilumab reduce the risk of death and the need for ventilators in patients with coronavirus, according to a clinical protocol in which 11,000 patients have participated.
The study was published in the Journal of the American Medical Association and led the World Health Organization (WHO) to recommend the use of these drugs, called IL-6 inhibitors, in addition to corticosteroids in patients with severe or critical covid.
Tocilizumab and sarilumab are used to treat rheumatoid arthritis, an autoimmune disease, by inhibiting the effects of interleukin IL-6, a type of protein called a cytokine that causes the body to increase an inflammatory response. Manu Shankar-Hari, lead author of the study, said the research represented “definitive evidence” in favor of the drugs after studies that showed mixed results.
Tocilizumab is the second drug ever recommended by WHO for treatment against coronavirus after recommending dexamethasone in September 2020. It belongs to the class of drugs called monoclonal antibodies (mAbs), which are used in the treatment of various diseases. , including cancers.
Although tocilizumab has been on the market since 2009 for the treatment of rheumatologic diseases, access remains a challenge.
Among hospitalized Covid patients, administering any of the drugs in addition to corticosteroids reduced the risk of death by 17%, compared to using corticosteroids alone.
In patients who were not on a ventilator, the risk of switching to mechanical ventilation or dying was reduced by 21%, compared to using corticosteroids alone.
This prompted the WHO to coordinate the new study which combined data from 27 randomized trials conducted in 28 countries.
Outcomes were best when patients also received corticosteroids, with a 21 percent risk of death versus 25 percent for those receiving usual care. This means that for every 100 of those patients, four more will survive.
The study also looked at the impact of these drugs on patients’ progression to ventilators or death.
Among patients who also received corticosteroids, the risk was found to be 26% for those receiving IL-6 inhibitors, compared with 33% assumed for those receiving usual care.